Simple limbal epithelial transplantation (SLET) in a patient with limbal stem cell deficiency.

S76

Transplantation

www.transplantjournal.com

331.2

Laparoscopic transperitoneal living donor nephrectomy

early experience at a single center in Saudi Arabia.

Hossam S El-Tholoth,

_{Hamad Al Akrash,}

_{Rafat Zahid,}

Tarek Alzahrani,

_{Ali Obied,}

_{Ahmed Al Zahrani}

1

_{Urology Department, Prince Sultan Military Medical City, Riyadh,}

Saudi Arabia.

2

_{Transplantation Department, Prince Sultan Military Medical City,}

Riyadh, Saudi Arabia.

Background: Renal transplantation is an appropriate treatment for

end-stage renal disease. Laparoscopic donor nephrectomy has shown accretion

in popularity as an effective way of kidney donation. Herein, we aim to

pre-sent our early experience in laparoscopic donor nephrectomies.

Methods: All laparoscopic donor nephrectomies data collected from our first

case on 25-1-2016 till December 2018 were collected. Their demographic

data, transfusion requirement, ischemia time intraoperative finding and

post-operative complications were reviewed.the data were analyzed using SPSS

statistical package were conducted.

Results: 238 laparoscopic donor nephrectomies were done in this period

183 male 55 female with age range between(18-54) and average body mass

index 30.8, 233 left side only 5 right side nephrectomies done. Seventy eight

hand-assisted laparoscopic nephrectomy and 160 laparoscopic

nephrecto-mies with a mean warm ischemia time 3 min 12 sec and mean blood loss

is 75 ml. No patients needed blood transfusion the mean operative time 75

mints. Regarding Post-operative complication 7 patients have grade I and

II surgical complications and managed conservatively. No statistically

sig-nificant difference between the two laparoscopic techniques regarding the

operative time and warm ischemia time. The mean hospital stays for 2.4

days.

Conclusions: Laparoscopic donor nephrectomy has an excellent surgical

outcome and no significant postoperative complications and short hospital

stay.

331.3

Simple limbal epithelial transplantation (SLET) in a patient

with limbal stem cell deficiency.

Leyla Asena, Dilek Dursun Altınors, Sibel Oto

Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.

Objective: To present a case with unilateral limbal stem cell deficiency who

was treated with simple limbal epithelial transplantation (SLET).

Methods: A 78-year-old male patient admitted to our clinic with long

stand-ing herpetic stromal keratitis in his left eye. He was treated with systemic

and topical antiviral medication and topical corticosteroids. The inflammation

was inactive however there was a vascularized pannus covering the entire

corneal periphery indicating corneal limbal stem cell deficiency, resulting

in decreased visual acuity. Simple limbal epithelial transplantation from the

healthy contralateral eye was performed.

Results: A 2 × 2 mm strip of donor limbal tissue was obtained from the

healthy eye and divided into eight to ten small pieces. After surgical

prepara-tion of the recipient ocular surface, these tiny limbal transplants were

dis-tributed evenly and attached using fibrin tissue adhesive over an amniotic

membrane placed on the cornea. At the fourth postoperative week a

com-pletely epithelialized, avascular and stable corneal surface was observed and

this was maintained during a follow-up of 9 months. Best corrected Snellen

visual acuity improved from 0.5 to 0.9. Figures 1, 2 and 3 show

preopera-tive, postoperative first day and postoperative first month anterior segment

photographs of the patient.

Conclusions: SLET is a relatively new surgical technique for limbal stem

cell transplantation which requires less donor tissue than previously used for

conventional autografting and does not need a specialist laboratory for cell

expansion. It is an easy and effective technique for treating unilateral limbal

stem cell deficiency.

© 2019 Wolters Kluwer

Abstracts

S77

331.4

Clinical outcomes of deep anterior lamellar keratoplasty

(DALK) in keratoconus patients.

Dilek Dursun Altınors, Leyla Asena,1 Sibel Oto

Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.

Objective: To report the clinical outcomes of deep anterior lamellar

kerato-plasty (DALK) in keratoconus patients.

Methods: Ten eyes of 10 patients with high grade keratoconus who

under-went DALK between January 2018 and January 2019 were included. Patient

records were reviewed retrospectively. Demographic characteristics,

dura-tion of follow-up, pre- and postoperative visual acuity, objective refracdura-tion,

complications were recorded.

Results: The mean patient age was 37.6 years. The male/female ratio was

8/2. All patients were contact lens intolerant and 6 patients had corneal

stro-mal opacities. Duration of postoperative follow-up was 6.3±4.3 months. At

latest follow-up, Snellen BCVA of 0.8 or better was present in 4 eyes (40%),

0.5-0.8 in 5 eyes (50%) and 0.5 or worse in 1 eye (10%). The mean

preop-erative refractive cylinder was 5.42±3.55 D and decreased to 3.20±2.42 D

at the end of postoperative follow-up (p<0.05). There was an intraoperative

micro perforation in 2 eyes and DALK could be completed successfully in

all patients. Big bubble could be obtained in 4 patients and manual lamellar

dissection was used in the rest of the patients. Figure 1 shows

intraopera-tive image of the patient during lamellar dissection of the recipient bed. No

rejection episodes were observed postoperatively. 4 patients had minimal

interphase clouding which did not cause significant visual disturbance.

Conclusions: DALK is a useful and safe procedure for corneal

transplan-tation in keratoconus patients. Micro perforations during surgery are the

main intraoperative complication however most can be handled successfully

without conversion to penetrating keratoplasty. Manual lamellar dissection

can be performed safely in cases where the big bubble formation cannot

be achieved.